Maternal-fetal outcomes of pregnancies with thrombocytopenia-one center experience

Abstract

Objective: To investigate the etiology, obstetric risk factors, complications, and outcomes of pregnancies affected by thrombocytopenia. Material and Methods: A retrospective surveillance study was conducted based on the hospital records of 1286 women that gave birth during the period between 1st January 2017 and 31st December 2018 at the Department of Gynecology and Obstetrics of the Trakya University's School of Medicine. Clinical data including basic history, physical examination, and investigations of women with thrombocytopenia were evaluated. We randomly selected 154 patients without thrombocytopenia that delivered in our clinic during the same period, as the control group, and compared the maternal and fetal outcomes with the thrombocytopenic patient group. Results: A total of 154 out of 1286 women (11.9%) had thrombocytopenia of varying severity. Gestational thrombocytopenia (GT) was the most common cause, being identified in 76.2% of the cases with thrombocytopenia. This was followed by preeclampsia (15.5%). About 4.5% of pregnant women with thrombocytopenia were accounted for by idiopathic thrombocytopenic purpura (ITP), 2.5% of the patients by eclampsia, while HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome was observed in 1.3% of the pregnant women with thrombocytopenia. An increased rate of IUGR (Intrauterine growth restriction), fetal distress, and adverse neonatal outcomes were recorded among patients that had thrombocytopenia with preeclampsia, eclampsia, and HELLP syndrome. Furthermore, we observed higher rates of fetal distress and adverse neonatal outcomes in patients with thrombocytopenia compared to the control group. Conclusion: GT was the most common cause of thrombocytopenia in pregnancy, followed by preeclampsia. Eclampsia, HELLP syndrome, and ITP were rare causes of this disorder during pregnancy. Early detection and treatment of expected complications are critical for the effective management of such cases.